OBJECTIVE To construct ensemble learning models for predicting high-use days of budesonide based on meteorological factors， thereby providing reference for hospital pharmacy management. METHODS Meteorological data for 2024 and outpatient budesonide usage data from the jurisdiction of Sanming Hospital of Integrated Traditional Chinese and Western Medicine were collected. High-use days were defined as the 75th percentile of outpatient budesonide usage， and a corresponding dataset was established. The prediction task was formulated as a classification problem， and three ensemble learning models were developed： Random Forest， Extreme Gradient Boosting （XGBoost）， and Histogram-based Gradient Boosting Classifier. Model performance was evaluated using accuracy， precision， recall， F1-score， and log-loss. Model interpretability was analyzed using Shapley Additive Explanations （SHAP）. RESULTS The Histogram-based Gradient Boosting Classifier achieved the best performance （accuracy＝0.75， F1-score＝0.48）， followed by XGBoost （accuracy＝0.74， F1-score＝0.43） and Random Forest （accuracy＝0.72， F1-score＝0.22）. SHAP results suggested that the prediction results of the last two models have the highest correction. CONCLUSIONS Ensemble learning models can effectively predict high-use days of budesonide， with the Histogram- based Gradient Boosting Classifier demonstrating the best predictive performance. Low temperature， high humidity， and low atmospheric pressure show significant positive impacts on the prediction of daily budesonide usage.

Objective:To compare the survival outcomes of different subsequent treatment regimens in patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) who achieved partial response (PR) after neoadjuvant chemotherapy based on the gross tumor volume regression rate (GTVRR).Methods:This retrospective study included patients with locally advanced HPSCC treated at the Department of Head and Neck Surgery, Beijing Tongren Hospital, from January 2011 to December 2023. The cohort included 135 males and 3 females, aged from 35 to 77 years. All patients received 2-3 cycles of TPF regimen (paclitaxel+cisplatin+5-fluorouracil) neoadjuvant chemotherapy. Subsequent treatments included concurrent chemoradiotherapy or surgery combined with postoperative adjuvant radiotherapy. The impacts of different subsequent treatment modalities on the survivals and prognoses of patients were compared based on GTVRR thresholds of 50% and 70%. The χ 2 test was used to analyze influencing factors; survival analysis and intergroup comparisons were performed using the Kaplan-Meier method and Log-rank test; prognostic factors were assessed using univariate and multivariate Cox regression analyses. Results:The 5-year OS and PFS rates were 56.5% and 47.9%, respectively, while, the 10-year OS and PFS rates were 25.8% and 21.2%, respectively. The median OS was 75 months, and the median PFS was 48 months. The laryngeal function preservation rate for the entire cohort was 83.3%. The patients who underwent surgery combined with postoperative radiotherapy had significantly better OS and PFS outcomes than those treated with concurrent chemoradiotherapy ( P<0.05). Stratification based on GTVRR revealed that the surgery plus postoperative radiotherapy regimen was particularly effective for PR patients with a GTVRR of 30%-70%, showing significantly better OS and PFS compared to the concurrent chemoradiotherapy group ( P<0.05). Conclusion:The optimal subsequent treatment for PR-HPSCC may be surgery-based comprehensive treatment, particularly for patients with a GTVRR of 30%-70%. This study offers valuable insights for the stratified treatment of HPSCC, which could contribute to improving overall patient prognosis.

Objective To explore the effect of positive ruminative thinking training(PRT)on negative emotions during modified electroconvulsive therapy(MECT)in depression patients.Method A total of 80 patients with depression who received MECT at Ganzhou Third People's Hospital from February 2024 to February 2025 were selected as subjects.Using a random number table method,they were divided into control group(n=40)and observation group(n=40).The control group received standard interventions,while the observation group received PRT in addition to control group's interventions.Both groups continued treatment until the completion of MECT,with all patients receiving 8-12 sessions of MECT.Negative emotions,self-efficacy,and the positive and negative ruminative thinking(PNR)scale were compared between two groups.Before and after intervention,adverse reactions were evaluated in both groups post-treatment.Results After intervention,the scores of anxiety,depression scale,and negative factor rumination thinking in observation group were lower than those in control group.The scores of general self-efficacy scale and positive factor rumination thinking were higher than those in control group,and the differences were statistically significant(P＜0.05).The total incidence of adverse reactions in observation group was lower than that in control group(P＜0.05).Conclusion PRT can reduce negative emotions and negative rumination thinking in depression patients during MECT,improve positive rumination thinking and self-efficacy.

Objective:To explore the role and related mechanism of myeloid related differentiation markers (MYADM) in lung adenocarcinoma metastasis induced by high cholesterol diet.Methods:(1) Cell experiments: Using lung adenocarcinoma A549 and H1975 cells, the cells were treated with 0.8 mg/ml cholesterol and then transfected with a lentivirus to knock down MYADM. The overexpression of MYADM was achieved by transfecting the cells with an overexpression plasmid. Western blotting was used to detect the expression levels of MYADM, E-cadherin, β-catenin, MMP-2, MMP-9, and vimentin in the cells. The proliferation ability of the cells was assessed using the plate clonal formation assay, while the migration and invasion ability were evaluated using the Transwell assay. Western blot was used to determine the effects of MYADM knockdown or overexpression on these proteins. Western blot and immunofluorescence assays were conducted to investigate the impact of Akt phosphorylation on the expression of MYADM and Rac1 in cholesterol-treated lung adenocarcinoma cells, as well as the phosphorylation of c-Myc. Western blot was also used to assess the effect of c-Myc knockdown on the expression of MYADM and MCT1 in lung adenocarcinoma cells. Chromatin immunoprecipitation (ChIP) assays were performed to investigate the impact of cholesterol on the binding between c-Myc and the promoters of MYADM and MCT1 in lung adenocarcinoma cells. (2) Animal experiment: A549 cells or A549 cells with MYADM knockdown were intravenously inoculated into BALB/c nude mice, which were then divided into a normal diet group and a high cholesterol diet group. Using a live imaging system, the growth and metastasis of tumors in the mice were monitored. After 42 days, lung tissues were collected for immunohistochemical staining to detect changes in relevant proteins.Results:After cholesterol treatment, the expression level of MYADM in A549 cells increased from 1.00±0.18 to 3.28±0.28 ( P<0.001), and in H1975 cells, it increased from 1.00±0.06 to 2.03±0.10 ( P<0.001). Compared with the control group, the expression of E-cadherin in lung adenocarcinoma cells after MYADM knockdown increased ( P<0.01), while the expressions of β-catenin, MMP-2, MMP-9, and vimentin decreased (all P<0.01). After MYADM knockdown, the number of clonal plates decreased in A549 cells (203±23 vs 60±18, t=8.48, P=0.001) and H1975 cells (298±64 vs 137±51, t=3.41, P=0.271). The number of invasive cells also decreased in A549 cells (212±18 vs 99±34, t=5.09, P=0.007) and H1975 cells (268±34 vs 134±14, t=6.31, P=0.003). Additionally, the number of migratory cells decreased in A549 cells (353±37 vs 124±29, t=8.44, P=0.001) and H1975 cells (279±41 vs 79±19, t=7.67, P=0.002). In the lung adenocarcinoma cells overexpressing MYADM, the expression of E-cadherin decreased ( P<0.01), while the levels of β-catenin, MMP-2, MMP-9, and vimentin increased (all P<0.01). The number of plate clonal colonies formed by lung adenocarcinoma cells overexpressing MYADM increased significantly in A549 cells, (94±26 vs 298±34, t=8.26, P=0.001) and H1975 cells (83±13 vs 331±24, t=15.74, P<0.001). The number of invasive A549 cells also increased (118±17 vs 193±24, t=4.41, P=0.012) and (156±19 vs 321±12, t=12.72, P<0.001). Additionally, the number of migrating cells increased in A549 cells (171±22 vs 284±15, t=7.35, P=0.002) and in H1975 cells (178±7 vs 263±12, t=10.6, P<0.001). Experiments related to the molecular mechanism showed that overexpression of MYADM promotes the expression of MCT1 in lung adenocarcinoma cells (all P<0.01). Cholesterol not only enhances the expression of MYADM in lung adenocarcinoma cells, but also boosts the expression of Rac1 and MCT1, as well as the phosphorylation of Akt and c-Myc (all P<0.05). Immunoprecipitation experiments revealed that in A549 cells treated with cholesterol, MYADM-Rac1 interaction levels increased from (100.0±15.9)% to (191.0±26.7)% ( P=0.007), while in H1975 cells, the levels increased from (100.0±18.2)% to (170.0±27.5)% ( P=0.021). ChIP confirmed that cholesterol treatment enhances the binding of c-Myc to the promoters of MYADM and MCT1. In vivo experiments demonstrated that a high-cholesterol diet promotes the metastasis of lung adenocarcinoma cells in mice, inducing the expression of MYADM, MCT1, and Rac1, as well as the phosphorylation of Akt and c-Myc in mouse lung tissue. Conversely, knocking down MYADM inhibits the metastasis of lung adenocarcinoma cells in mice, suppressing the expression of MYADM, MCT1, and Rac1, as well as the phosphorylation of Akt and c-Myc in mouse lung tissues. Conclusion:Cholesterol may induce lung adenocarcinoma cells proliferation and metastasis by regulating the MYADM/Rac1/Akt/c-Myc/MCT1 axis.

OBJECTIVE To investigate the prognostic factors of chondrosarcoma of the larynx,deeply analyze its clinical data,and provide a theoretical basis for better treatment of chondrosarcoma of the larynx.METHODS A retrospective analysis was conducted on the complete clinical data of patients with primary chondrosarcoma of the larynx admitted to the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University from January 2010 to December 2024.RESULTS A total of 15 patients were included,including 11 males and 4 females,with a gender ratio of 11∶4.The average age of onset was 57.3 years,and the average clinical symptom duration was 12.2 months.The tumors were mainly located in the cricoid cartilage in 11 patients,in the arytenoid cartilage in 2 patients,and in the thyroid cartilage in 2 patients.Tumor grading showed that 7 patients were grade I and 8 were grade II.Four patients underwent transoral laser minimally invasive surgery,2 patients underwent partial laryngectomy+tracheotomy,and 9 patients underwent total laryngectomy/cervical lymph node dissection+tracheostomy.The 5-year overall survival rate was 85.7%,the 5-year disease-specific survival rate was 100%,and the 5-year local-regional control rate was 90.9%.Gender,tumor location,tumor grade,Ki-67,tumor size,and whether larynx preservation surgery was performed did not affect the local-regional control rate or disease-specific survival rate.CONCLUSION Laryngeal chondrosarcoma generally has a longer disease history and is difficult to detect.The pathological type is mostly well-differentiated.Regional or distant metastasis is rare,and the long-term survival rate is good.Surgical resection is the preferred treatment option.On the basis of not reducing the tumor control rate,surgery that prioritizes preserving laryngeal function should be given priority,while comprehensive treatment is generally not recommended.

Objective To explore the pathogenesis and prognostic factors of liposarcoma in the head and neck region, and simultaneously analyze the efficacy of different treatment regimens. Methods A retrospective analysis was performed on all patients with primary untreated head and neck liposarcoma who were diagnosed and underwent surgical treatment at our hospital from January 2008 to January 2024. All patients were monitored during follow-up, and their prognoses were analyzed using SPSS software. Results A total of 30 patients were included in the study. Liposarcoma accounted for up to 60% of the cases in the orbit, while the remaining liposarcomas were primarily located in various interspaces of the neck. Dedifferentiated liposarcoma was the most common type, comprising 33%, while myxoid pleomorphic liposarcoma was the rarest at 4%. The tumor pathological type (P<0.001) and Ki67 (P=0.014) significantly affected the tumor control rate. However, an analysis of disease-specific survival rates revealed no significant differences across various factors (all P>0.05). Conclusion The prognosis of head and neck liposarcoma is better compared to that of liposarcomas in other parts of the body. However, myxoid pleomorphic liposarcoma, pleomorphic fat sarcoma, and high Ki67 levels are indicators of poor prognosis. Additionally, postoperative adjuvant radiotherapy does not significantly enhance disease-specific survival rates.

Objective:To explore the application value of CT-guided percutaneous coaxial needle biopsy (CT-PTCB) in the diagnosis of malignant tumors.Methods:A retrospective case series study was conducted. The clinical data of 802 suspected malignant tumor patients who underwent CT-PTCB upon admission to Beijing Chaoyang District Huanxing Cancer Hospital from January 2019 to December 2023 were analyzed. All patients underwent imaging follow-up combined with CT-PTCB or surgical pathology to determine the final diagnosis. The CT-PTCB puncture effect, diagnosis effect and incidence of complications were recorded.Results:Among the 802 patients, 488 (60.8%) were male and 314 (39.2%) were female, with the age of (51±11) years. The puncture sites included 610 cases (76.1%) in the chest, 169 cases (21.1%) in the abdomen, 17 cases (2.1%) in the bones, and 6 cases (0.7%) in the pelvic cavity. The success rate of CT-PTCB puncture upon admission was 99.5% (798/802), the diagnostic accuracy was 96.5% (774/802), and the false negative rate was 3.5% (28/802). The incidence of pneumothorax and bleeding in patients undergoing pulmonary CT-PTCB was 13.0% (75/575) and 17.9% (103/575), respectively; the incidence of puncture bleeding in patients undergoing liver CT-PTCB was 0.8% (1/125), and the incidence of pain was 1.6% (2/125); the incidence of pneumothorax in patients undergoing mediastinal CT-PTCB was 8.7% (2/23); no obvious complications were observed in other puncture sites. All complications were cured through active treatment.Conclusions:The application of CT-PTCB for the diagnosis of malignant tumors has high success rate and diagnosis rate, and is safe and minimally invasive.

OBJECTIVE To explore the mechanism by which Gongfa Static Training regulates mitophagy through the PTEN-in-duced kinase 1(PINK1)/Parkin pathway in skeletal muscle insulin resistance in type 2 diabetes mellitus(T2DM).METHODS T2DM mouse model was established using a high-fat diet combined with streptozotocin(STZ)intraperitoneal injection.Mice were ran-domly divided into a model group,a metformin group,an aerobic exercise group,and a Gongfa Static Training group.The intervention effects of Gongfa Static Training were evaluated by measuring fasting blood glucose,Homeostatic Model Assessment of Insulin Resist-ance(HOMA-IR),glycated hemoglobin(HbA1c),lipid metabolism indicators,mitochondrial function in the gastrocnemius muscle,and the expression of PINK1 and Parkin-related genes and proteins.RESULTS Gongfa Static Training significantly reduced fasting blood glucose,HbA1c,and insulin resistance index in T2DM mice,improved lipid metabolism,and enhanced insulin sensitivity.It improved the structure and function of mitochondria in the gastrocnemius muscle by upregulating the mRNA and protein expression of PINK1 and Parkin.CONCLUSION Gongfa Static Training improves mitochondrial function and insulin resistance in the skeletal muscle of T2DM mice by regulating the PINK1/Parkin pathway.

Objective To establish and validate a human comfort evaluation method based on musculoskeletal activity in biomechanics.Methods Firstly,the limitations of current biomechanical-based comfort evaluation method were analyzed.Secondly,a new evaluation method based on musculoskeletal activity was proposed,which considered the influence of muscle and joint on comfort,and a comfort index was obtained.Finally,the firefighter's water belt rolling task was selected for verification.Results The comfort index derived from the improved musculoskeletal activity-based evaluation method was 0.74,which was lower than the comfort index of 0.82 obtained from the comfort based on muscle activity.The verification results aligned with the theoretical analysis.A questionnaire survey conducted on 43 firefighters showed that the subjective assessments gathered were consistent with the verification outcomes,further confirming the conclusion that the former method was more comprehensive and accurate.Conclusions Compared to the method that focuses exclusively on muscle activity,the comfort evaluation method that integrates both muscle and joint conditions not only more accurately reflects the actual state of the human body but also comprehensively identifies potential biomechanical risks,thereby demonstrating greater practical significance.